92 Decision Citation: BVA 92-02865
Y92
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 91-19 033 ) DATE
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THE ISSUES
1. Entitlement to service connection for tinnitus.
2. Entitlement to an increase in the 20 percent evaluation
currently assigned for hypertension.
3. Entitlement to an increase in the 10 percent evaluation
currently assigned for dermatitis.
4. Entitlement to an increased (compensable) evaluation for
calluses of the feet.
5. Entitlement to an increased (compensable) evaluation for
defective hearing.
6. Entitlement to an increased (compensable) evaluation for
residuals of rhinoseptoplasty.
7. Entitlement to an increased (compensable) evaluation for
traumatic arthritis of the right knee.
REPRESENTATION
Appellant represented by: The American Legion
ATTORNEY FOR THE BOARD
Christopher Maynard, Associate Counsel
INTRODUCTION
The veteran had active service from February 1953 to
February 1973.
The veteran requested that his claim be reopened in a state-
ment received on June 16, 1989. A subsequent rating decision
by the Columbia, South Carolina, Regional Office on July 16,
1990, granted an increase to 20 percent for hypertension and
continued the 10 percent evaluation for dermatitis and the
noncompensable evaluations for calluses of the feet, defec-
tive hearing, residuals of rhinoseptoplasty and traumatic
arthritis of the right knee. The veteran was dissatisfied
with this decision and appealed. A notice of disagreement
was received on August 16, 1990, and the statement of the
case was issued on November 19, 1990. The substantive
appeal was received on January 10, 1991, and a supplemental
statement of the case was issued on February 4, 1991. The
appeal was received at the Board on April 23, 1991, and
docketed on April 29, 1991. The appellant has been repre-
sented throughout his appeal by The American Legion, and
that organization submitted additional written argument to
the Board on May 13, 1991.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends that his service-connected disabilities
are more severe than currently evaluated. Additionally, the
veteran complains of persistent ringing in his ears.
DECISION OF THE BOARD
For the reasons and bases hereinafter set forth, it is the
decision of the Board that the preponderance of the evidence
is against the claims for increased evaluations for hyperten-
sion, dermatitis, defective hearing and residuals of rhino-
septoplasty. The record supports the assignment of increased
ratings to 10 percent for calluses of the feet and for
traumatic arthritis of the right knee, and a grant of service
connection for tinnitus.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable disposi-
tion of the veteran's appeal has been obtained by the agency
of original jurisdiction.
2. The veteran's hypertension is manifested principally by
complaints of occasional dizziness and headaches associated
with elevated diastolic blood pressure readings of not more
than 112. A history of diastolic blood pressure readings
predominantly 120 or more or other moderately severe
symptoms have not been demonstrated.
3. The veteran's service-connected dermatitis is manifested
principally by a scaly, hyperkeratotic eruptions over the
dorsal aspect of his hands and fingers without erythema,
exudation, extensive lesions or marked disfigurement.
4. The veteran's service-connected foot disorder is mani-
fested principally by complaints of daily foot pain and
callous formations on both feet and requires the wearing of
orthopedic shoes with metatarsal bars.
5. The December 1989 VA audiological evaluation showed an
average pure tone threshold of 49 decibels in the right ear
and 46 decibels in the left ear at the four frequencies from
1,000 to 4,000 hertz. Speech discrimination ability was
92 percent bilaterally, which translated to a numeric
designation of I for each ear.
6. Marked interference with breathing or other current
residuals of the veteran's rhinoseptoplasty have not been
demonstrated.
7. Traumatic arthritis of the right knee is manifested prin-
cipally by pain on motion, crepitus and X-ray evidence of
effusion in the suprapatellar bursa, without limitation of
motion.
8. Tinnitus is probably related to the veteran's noise-
induced hearing loss due to service.
CONCLUSIONS OF LAW
1. The criteria for a rating in excess of 20 percent for
hypertension are not met. 38 U.S.C. §§ 1155, 5107 (1989)
(formerly §§ 355, 3007, recodified in 1991); 38 C.F.R. Part
4, Code 7101 (1991).
2. The criteria for a rating in excess of 10 percent for
nonspecific dermatitis are not met. 38 U.S.C. § 1155, 5107
(1989); 38 C.F.R. § 4.20, Part 4, Codes 7813-7806 (1991).
3. The criteria for an increased rating of 10 percent for
calluses of the feet are met. 38 U.S.C. §§ 1155, 5107
(1989); 38 C.F.R. § 4.20, Part 4, Code 5279 (1991).
4. The schedular requirements for a compensable evaluation
for defective hearing have not been met. 38 U.S.C. §§ 1155,
5107 (1989); 38 C.F.R. § 4.85, Part 4, Code 6100 (1991).
5. The criteria for an increased (compensable) evaluation
for residuals of rhinoseptoplasty are not met. 38 U.S.C.
§§ 1155, 5107 (1989); 38 C.F.R. § 4.20, Part 4, Codes 6599-
6502 (1991).
6. The criteria for an evaluation of 10 percent for
traumatic arthritis of the right knee are met. 38 U.S.C.
§§ 1155, 5107 (1989); 38 C.F.R. § 4.59, Part 4, Codes 5003,
5010, 5257, 5260, 5261 (1991).
7. The veteran's tinnitus is proximately due to or the
result of service-connected disability. 38 U.S.C. § 5107
(1989); 38 C.F.R. § 3.310(a) (1991).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
We note that the veteran's claim is well grounded within the
meaning of 38 U.S.C. § 5107(a) (1989), and we are satisfied
that all relevant facts have been properly developed in
accordance with the above-cited law.
(A)
Service medical records showed treatment for elevated blood
pressure readings beginning as early as November 1967. When
examined by the VA in June 1973, mild essential hypertension
was diagnosed; no other significant cardiovascular abnormali-
ties were noted. In evaluating the current degree of impair-
ment due to the veteran's hypertension, consideration has
been given to the clinical record in its entirety, including
the numerous VA examinations and progress notes from 1973
through 1990. In this regard, we find no evidence of any
diastolic blood pressure reading of 120 or more. Despite the
veteran's complaints of occasional dizziness and headaches,
his blood pressure was 170/112 when examined by the VA in
December 1989 and his heart rate and rhythm were normal.
Despite the fact that his hypertension is apparently poorly
controlled with medication, his diastolic blood pressure has
remained well below 120 and moderately severe symptoms have
not been demonstrated. Accordingly, a higher evaluation
under the provisions of Diagnostic Code 7101 is not
warranted.
(B)
Service medical records reflect that the veteran was treated
with cortisone-type medications for intermittent problems
with a rash on his hands. When examined by the VA in June
1973, there was no evidence of any dermatological abnormali-
ties on the skin surface of the right hand; there was no
opportunity to observe the left hand as it was encased in a
plaster cast. The record indicates that the veteran's rash
had spread to other areas of his hands and fingers and the
disability evaluation was increased to 10 percent in 1981.
When examined by the VA in December 1989, the veteran com-
plained of itching and scaly, hyperkeratotic eruptions on
the dorsal aspects of the hands and several fingers was
noted. While the veteran is still using cortisone-type
creams for control of his skin rash, the current findings do
not show exudation, extensive lesions or marked disfigurement
which is necessary for a higher evaluation under Diagnostic
Code 7806.
(C)
The veteran's service medical records show occasional treat-
ment for complaints of sore feet manifested by calluses on
the plantar aspects of both feet. Similar findings were
noted on his separation examination in September 1972. When
examined by the VA in June 1973, the veteran had calluses
under the heads of the 2nd and 5th metatarsal bones and the
proximal phalangeal joints of the first digits on both feet
which were not particularly tender. The veteran was seen on
numerous occasions since service separation for complaints
of pain in the metatarsal region of both feet and was issued
orthopedic shoes with metatarsal bar inserts in 1986. In
our opinion, an analogous rating to metatarsalgia (Diagnostic
Code 5279) more accurately reflects the veteran's bilateral
foot symptomatology. Accordingly, we find that a 10 percent
evaluation for the veteran's bilateral foot disorder is
warranted.
(D)
For the purpose of evaluating the degree of disability due
to service-connected defective hearing, disability ratings
are based upon a comparison of the certified audiometric
test results at authorized facilities with the criteria set
out in a schedule for rating disabilities which is based on
average impairment of earning capacity. While we recognize
that the veteran does have difficulty hearing in groups and
with background noise when not wearing his hearing aids, the
most recent VA examination conducted in December 1989 did
not show his hearing loss was so severely disabling as to
warrant a compensable rating under the above-cited criteria
at this time. Those findings revealed level I hearing loss
bilaterally. Such results would not permit the assignment
of a compensable evaluation.
(E)
Service medical records show that the veteran injured his
nose in a skating accident in January 1972 and underwent
corrective surgery for a deviated nasal septum without
complication in or around August 1972. Followup examination
in August 1972 showed no obstructions with excellent airing
through both nostrils. The veteran has apparently required
no subsequent treatment. When examined by the VA in December
1989, no marked interference of breathing was noted. There-
fore, there is no basis to grant a compensable evaluation.
(F)
Service medical records showed treatment for complaints of
right knee pain on numerous occasions during service.
Although no specific trauma to the right knee was ever
reported, it was felt that his knee complaints were indica-
tive of prolonged trauma resulting in chondromalacia of the
right knee joint. When examined by the VA in December 1989,
the veteran had full range of motion of the right knee with
no joint instability. However, there was crepitus on range
of motion exercises and pain was elicited at extreme exten-
sion. The Board finds that a 10 percent evaluation is
warranted under the provisions of 38 C.F.R. § 4.59 (1991)
for painful motion.
(G)
The veteran's service medical records showed that he worked
around a flight line for most of his career and had com-
plained of ringing on at least two occasions in service in
November and December 1966. Additionally, tinnitus was
noted on VA audiological examination in December 1989. The
record indicates that the veteran's defective hearing was
noise induced and, as tinnitus is often related to noise-
induced hearing loss, we believe that service connection is
warranted.
ORDER
Service connection for tinnitus is granted.
Increased evaluations of 10 percent for calluses of the feet
and of 10 percent for traumatic arthritis of the right knee
are granted, subject to the laws and regulations regarding
payment of monetary benefits.
Increased evaluations for hypertension, dermatitis, defective
hearing and residuals of rhinospetoplasty are denied.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
STEPHEN L. WILKINS U. H. ANG, M.D.
38 U.S.C. § 7102(a)(2)(A) (1991) (formerly § 4002(a)(2)(A))
permits a Board of Veterans' Appeals Section, upon direction
of the Chairman of the Board, to proceed with the transaction
of business without awaiting assignment of an additional
Member to the Section when the Section is composed of fewer
than three Members due to absence of a Member, vacancy on
the Board or inability of the Member assigned to the Section
to serve on the panel. The Chairman has directed that the
Section proceed with the transaction of business, including
the issuance of decisions, without awaiting the assignment
of a third Member.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C. § 7266 (1991)
(formerly § 4066), a decision of the Board of Veterans'
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of Disagree-
ment concerning an issue which was before the Board was
filed with the agency of original jurisdiction on or after
November 18, 1988. Veterans' Judicial Review Act, Pub. L.
No. 100-687, § 402 (1988). The date which appears on the
face of this decision constitutes the date of mailing and
the copy of this decision which you have received
is your notice of the action taken on your appeal by the
Board of Veterans' Appeals.